Inconsistent Prescribing of Anti-Anxiety Meds a Concern During—and After—Pandemic

With drug overdose deaths reaching historic levels during the COVID-19 pandemic, researchers from the Lerner Center for Public Health Promotion at Syracuse University noted how inconsistent prescribing of anti-anxiety medications has been a significant contributing factor and will continue to be post-pandemic.

Two concerns around anti-anxiety medications had emerged before the pandemic, the Syracuse researchers noted: overprescribing of benzodiazepines and contaminated, counterfeit pills. The two concerns are linked: Given the highly addictive properties of benzodiazepines and harsh withdrawal symptoms, patients have been known to sometimes turn to illicit sources for pills, which can be laced with fentanyl and dramatically increase risk for overdose.

Prescriptions for benzodiazepines increased by 34.1% from February to March 2020, with an increase of 18% in the week of March 15 alone as stay-at-home orders began to go into effect. In the ensuing three months, however, prescriptions dropped as elective appointments with providers were limited by COVID-19 restrictions and even some of those who were able to maintain access to care through telehealth options were at risk of losing their prescriptions in other ways, such as loss of job and, therefore, employer-sponsored healthcare.

“Patients taking medications that cause dependence without access to legitimate prescriptions may resort to tainted, black market drug supplies, as was the case when prescription opioids became more difficult to get from physicians,” the researchers cautioned.

As the U.S. begins to emerge from the pandemic this year, the Syracuse researchers recommended that providers be aware to patients’ mental health conditions and use of benzodiazepines. Behavioral therapies and carefully monitored anxiety medications should be accessible, but providers should also be cautious of pushing patients off the medications too quickly, thereby creating situations in which they seek illicit alternatives. Prescribers should also urge patients to participate in virtual psychiatry and counseling services, and also weigh symptoms, therapy and eventual prescription reductions on a case-by-case basis.